Takano Yuichi, Nagahama Masatsugu, Yamamura Eiichi, Maruoka Naotaka, Mizukami Hiroki, Tanaka Jun-ichi, Ohike Nobuyuki, Takahashi Hiroshi
Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Yokohama, Kanagawa, 227-8501, Japan,
Clin J Gastroenterol. 2015 Jun;8(3):148-55. doi: 10.1007/s12328-015-0569-8. Epub 2015 May 8.
Mucinous cystic neoplasm of the liver (MCN-L) is a very rare tumor whose detailed behavior is still unknown. We describe two cases of MCN-L that exhibited extremely interesting growth patterns, and discuss the characteristics of MCN-Ls. Both cases exhibited MCN-L that originated from the left hepatic lobe (Segment 4) and then prolapsed into the left hepatic duct and common bile duct, resulting in obstructive jaundice due to expansive growth. Endoscopic retrograde cholangiopancreatographies showed the characteristic oval-shaped filling defects in the bile ducts. Endoscopic ultrasound and intraductal ultrasound were useful for differentiating the tumors from stones, since multiple septal formations were observed inside the tumors. A literature search revealed that, over the past 10 years, 15 cases of MCN-L (biliary cystadenomas with ovarian-like stroma) that showed expansive growth in the bile duct had been reported. Prolapse into the bile duct and expansive growth appear to be characteristic behavior of MCN-L. In the future, additional data on more cases needs to be collected to further elucidate MCN-L pathophysiology.
肝脏黏液性囊性肿瘤（MCN-L）是一种非常罕见的肿瘤，其详细行为仍不清楚。我们描述了两例表现出极其有趣生长模式的MCN-L病例，并讨论了MCN-L的特征。两例病例均显示MCN-L起源于肝左叶（第4段），然后脱垂至左肝管和胆总管，因肿瘤扩张性生长导致梗阻性黄疸。内镜逆行胰胆管造影显示胆管内有特征性的椭圆形充盈缺损。内镜超声和导管内超声有助于将肿瘤与结石区分开来，因为在肿瘤内部观察到多个间隔形成。文献检索显示，在过去10年中，已有15例MCN-L（具有卵巢样间质的胆管囊腺瘤）报告显示在胆管内有扩张性生长。脱垂至胆管并扩张性生长似乎是MCN-L的特征性行为。未来，需要收集更多病例的额外数据，以进一步阐明MCN-L的病理生理学。
